| NPI | 1972847929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 9624) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 019710) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2017-02-02 |